Primary Care Billing
The JBT Health & Wellness Center will begin accepting and billing health insurance for all primary care visits on July 1st, 2015.
Behavioral health visits will continue to not be subject to billing.
Benefits of JBT starting to bill insurance
Billing will allow JBT to continue to offer quality care without increasing costs to OHSU students and postdocs. Depending on the success of the effort, the types of services and hours may be able to be expanded in future years. Moving to a billing model will also allow for expanded primary care coverage for those who have the Oregon Health Plan (OHP). JBT's Primary Care providers will now be in network with a number of insurance carriers including OHP, Moda and PacificSource.
What will I pay (Covered Services)?
Primary care patients will not be subject to copays or deductibles when you use JBT's Primary Care clinic. JBT will not 'balance bill' students for the portion of insurance claims not paid by insurance with the exception of non-covered services such as pre-entrance immunizations and travel visit vaccines. As usual, all students or their insurance carriers will be responsible for additional charges for laboratory and other ancillary services sought/sent outside of JBT.
When insurance companies are billed, they require information regarding the components of the visit, including the diagnosis. If you are covered by your parent/guardian(s)/spousal insurance, they may get information from the insurance company regarding the charges and payment. If you have any concerns about this, please discuss this immediately with your clinician or the receptionist at the time of service. Procedures are available to help you maintain confidentiality. An alternative includes changing the visit type to self-pay which would result in a bill for services to be directly received by the student.
Insurance Plans in which JBT's Primary Care clinicians are participating providers with a number of health plans. Including:
· Oregon Health Plan
Please note our primary care providers, as are many of OHSU's primary care providers, are typically considered out of network for Kaiser, most Providence plans and Lifewise. While you are still welcome to be seen in JBT if you have this insurance, please note that any ancillary services, prescriptions and/or referrals may not be covered if ordered by a JBT primary care provider. Please contact your insurance carrier if you have any questions regarding coverage with your plan.
Some medical procedures at JBT will require pre-authorization dependent upon the student/postdoc's insurance carrier. Our managed care department will seek this pre-authorization from your insurance carrier. In these cases, JBT may be required to schedule out the procedure until that authorization can be obtained.
Services that will remain self-pay include (we will attempt to bill insurance and then if not covered, the student will be billed):
· Outside placement requirements
Students on the Student Health Insurance Plan will have acupuncture services covered at 100% with a JBT provider referral. Those with outside health insurance coverage will be subject to their plan's benefit coverage and co-pays and deductibles will apply.
As in the past, services and/or referrals that are ordered by our providers or labs that are drawn in our clinic but sent outside, will be billed separately to the patient from those ancillary departments. We do not dispense take home medication from the clinic. Prescriptions will be billed from the patient's pharmacy of choice. All expenses related to ancillary medical services or referrals outside of JBT are the responsibility of the student/postdoc and their health insurance company.
We are dedicated to helping patients understand the complex world of insurance billing and are available for any billing questions, concerns or problems relating to any clinic visits.